Essay on Resistance to the Single-Payer Healthcare System

Published: 2021/11/18
Number of words: 794

The healthcare finance structure comprises a complicated network of multiple payers involving private and government health insurance options. The Single-payer system was a term coined to differentiate the Canadian system from that of the United Kingdom, where the government takes responsibility for finance and delivery. However, the term has evolved to describe financing by a single public entity regardless of the delivery of care (Blahous, 2018). Recently, there have been proposals for a single-payer system at the national level. The health plan would be financed through taxes, provider payment reform and would cover all medically necessary services without cost-sharing. Under this plan, public programs such as Medicaid and Medicare would be turned over to the new project. However, the system has faced resistance from various stakeholders, including consumers, physicians, insurance companies, and pharmaceutical companies.

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Even though the single-payer plan would ensure universal coverage to consumers, the program has been widely criticized for burdening taxpayers. Petrou et al. (2018) highlight that the proposal would cost an additional $32 trillion and need a 20 percent tax increase. The Single-payer system would make the federal government the sole source of healthcare. Americans would be accorded “free” healthcare and would no longer be required to pay premiums or copays. Al health services ranging from major surgery to vision and hearing would be covered under the new plan. However, more than two-thirds of the American population does not support the plan, mainly due to the personal tax increase. Consumers are also concerned that the healthcare decisions would be taken away from their hands. They posit that socialized healthcare would give the government the power to decide who gets the care and when they get it. Patients also gear that the healthcare system could negatively impact the quality of care, leading to cancellations and delays in receiving care.

A study conducted by Duffin (2011) reveals that more than 50 percent of physicians support the single-payer system. Proponents argue that the plan will give doctors stability against the upheavals that come with healthcare reforms. Supporters of the project also cite that administrative burden would be lowered compared to other systems as the processing of payments would be done through one fee schedule. However, there is a probability that physicians would be under pressure to see more patients within a limited time with the program’s huge costs. Doctors should be alarmed by the single-payer system as it takes away their negotiating power (Woolhandler & Himmelstein, 2019). Under the current system, physicians can opt-out of Medicare and can choose not to do business with commercial payers that are burdensome. However, under a single-payer system, the doctors may not have an opportunity to opt out. Succinctly, major concerns by physicians have to do with the reduction in personal incomes and violation of their freedoms.

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On the other hand, the single-payer system risks throwing private insurance companies out of business. The system would place all consumers in the same insurance plan, thereby prohibiting private insurers as alternatives. This would take away the power of choice for consumers who are dissatisfied with the new healthcare system. The private health insurance industry is an aggressive opponent to the single-payer because it poses risks to the business’s survival. The single-payer system would significantly impact drug prices due to economies of scale (Cai et al., 2020). The United States would be able to decrease drug prices to the levels paid by countries with a single-payer system. This situation will favor patients who would access drugs at a lower price. However, the pharmaceutical companies would generate lower revenue because of lower prices. The ripple effect would be evident throughout the industry and extend to the supply chain.


Blahous, C. (2018). The costs of a national Single-Payer healthcare system. SSRN Electronic Journal

Cai, C., Runte, J., Ostrer, I., Berry, K., Ponce, N., Rodriguez, M., Bertozzi, S., White, J. S., & Kahn, J. G. (2020). Projected costs of single-Payer healthcare financing in the United States: A systematic review of economic analyses. PLOS Medicine17(1), e1003013.

Duffin, J. (2011). The impact of Single-Payer health care on physician income in Canada, 1850–2005. American Journal of Public Health101(7), 1198-1208.

Petrou, P., Samoutis, G., & Lionis, C. (2018). Single-Payer or a multipayer health system: A systematic literature review. Public Health163, 141-152.

Woolhandler, S., & Himmelstein, D. U. (2019). Single-Payer reform—“Medicare for all”. JAMA321(24), 2399.

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